[Sudden heart death in a long distance runner during a marathon]

Sudden cardiac death during running is mainly caused by an acute myocardial infarction and coronary artery disease. Other diseases like myocarditis are rarely documented. Before a marathon a 37-year-old, well-trained long-distance runner had normal findings at a sports medical consultation. During the race he collapsed after 41 km and died despite of immediate resuscitation attempts. At autopsy a 50% stenosis of the descending branch of the left coronary artery, and histologically an active myocarditis were observed (Dallas-classification). The endured extreme stress of the marathon probably resulted in arrhythmias and in sudden cardiac death.